Glasscock-Shambaugh EDITION EDITORS AINA JULIANNA GULYA,M D, FACS (Editor-in-Chief) ClinicParlo fessoorf Otolaryngology-Haenadd N eckS urgery The GeorgeW ashingtoUnn iversity WashingtonD,. C. FormerC hiefo fC linicTarli alBsr anch NationaIln stituont eD eafness aOntdh erC ommunication Disorders BethesdaM,a ryland LLOY D B.M INOR ,M D ,F ACS Provosatn d SenioVri ceP residenfto rA cademicA ffairs The JohnHso pkinsU niversity UniversiDtiys tinguisSheerdv icPer ofessoorf & Otolaryngology-HeadN eck Surgery The JohnsH opkinsU niversiStcyh oolo fM edicine BaltimorMea,r yland DENNIS S.P OE ,M D ,F ACS AssociatPer ofessoDre,p artmenotf O tologya nd Laryngology HarvardM edicaSlc hool Departmenotf O tolaryngoloagtyC hildrenH'oss pital BostonM,a ssachusetts VisitiPnrgo fessoDre,p artmenotf O tolaryngology TampereU niversiMteyd icaSlc hoolT,a mpere,F inland 2010 PEOPL'SE MEDICAPLU BLISHIHNOGU SE-USA SHELT ON,C ONNECTICUT PeoplMee'dsi caPlu blishHionugs eU·S A l EnterpsreiU rivSeu,i t5e0 9 Shelton, CT 06484 Tel2:0 3-402-0646 Fax: 203-4008254 - E-maiiln:f ol!i'pmpuhs a.com PMPH-USA 0 2010P M PH-USAL,t d. 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Emailk:a [email protected] AvenidMaa urilBiioa g2i8 50 United KingEduormo.p Mei,d dle CityR ibeirRaeob,e irParoe,t SoP Eats,A frica llrazil McGrawH ilEld uacti on Cl!P:1 4021-000 ShoppenhanRgocards Tel:0 800-992236 Maidenhead Fox1:6 -3939-9000 BerkshiSrLe62, Q L llma tieic:1 [email protected] NoticTeh:e a uthoarnsd p ublisher haveev emreayfd feo trote nsurteh atth ep atiecnatr ree commendheedr ein, includichnogk eo fd rug.san dd rugd osageissi, n a ccorwdi thth ea ccepteds tandaarndd p ractaitct eh el ime of publicatIil oowncv.c r,s incree searacnhdr egulatcioonns tancthlayn gdei nicsat.aIn dartdhser, e adeir>u rgetdo chectkh ep roducitn for111sah1eieiotn1 c1l udientd h ep ackagoefe achdr ugw,h ichi ncludreesc ommenddeods es, \'iarningsa.n dc ont.i rin dicaito11s".hI i'si �pa rI i curlaliym portant\\ 'inteh\'i o ri nfrequenutsleyddr ugsA.n yt ret.n aietn regmien,p articulalryo nei nvolvimnegd icJtiionnv,o livensh erernitst kh amtu stb ew eigheodna case-by-c•seb asis againstt heb enefi.trnst icipJTtheerd e. adeirsc autiontehdat th ep urposofet hibso oki sl oi nforamn de nlighten: thei nforamtoin cuntJanhcedr eiinsn ot inteansd,ae ndd s houlndo tb e emploaysea,d s ubs tiuttef ori ndividual diagnosisa ndt remJ�Cnt. Dedications Withm anyt hanktso m y ever-supportive husbanWdi,l liAa.mW ilsoMnD,, F ACS. A.J ULIANNGAU LYA,M D, FACS Withl ovaen da ppreciattoim oyn constantly supportwiivfeeL ,i saa,n do urc hildren, Emilayn dS am.I a lstoh anmky mentors fotrh ewiirs doma nds kimlyl ;p atienftosr theiinrs igahntdsp artnerswhiitpuhss i n ourc ollecqtuievsett o i mprovteh eliirv es; andm y colleagaunedss tudenftostr h eir keeni nsigahntdsd edicataisow ne pursue togethtehreg oaolf i ncreassicnige ntific knowledagned a dvancicnlgi niccaarle . LLOYDB .M INOR,M D,F ACS Tom y lovinagn dw onderfuslulpyp ortive wifeM,i lja-Rainidtc thai ldrLeanr aD,a niel, andS onjaA.l stoo our teawchhoe grasv,e ust hef oundatitoons esr voeu rp atients and toou rp atienwthso, h aveb eeno ur ultimaetdeu cators. DENNIS PSO.E ,M D,F ACS iii iv DEDICATIONS • (1890-1968) JULIUSL EMPERT • Foremosta dvocaotfet hee ndaural approacht hteto e mporbaoln eH.i s one-stafgeen estraotpieorna tiloendt ot he renaissaonfcr ee construscutirvgeef royr conducitve hearinlgo ss. 1924) JOHN J.S HEAJ R (BORN Revived • stapedectomy tmhoarhnea laf c entury afteBrl akaen dJ acka,d dinpgr osthetic retsorationo fo ssicucloanrt inufirtoym the incutso t issucoev ering theo vawli ndow. WILLIAMF. HOUSE,M D (BORN1 923) • The" fathoefrn eurotoloHgey p.i"o neered thee arldyi agnosainsdt ranslabyrinthine removaolfv estibuslcahrw annomaasn d thed evelopmeonftt h ec ochleiamprl ant. DEDICATIONS • v GEORGEE.SHAMBAUGH JR,MD (1903-1999} Authoorft hef irasntd • seconedd itioonfSs u rgeroyft heE ara nd seniocro authoofrt het hiredd ition. MICHAELE.G LASSCOCK1 1M1D,, F AGS • Editoofrt hef ouretdhi tioofn Surgery of the Ear and co-ediotfot rh ef ifth. Contents xi Foreword xiii Preafc e xv Contributors SECTIONI .S CIENTIFIC SECTIONI. I CLINICAELV ALUATION FOUNDATIONS AND REHABILITATION 1. DevelopmenAtnaalt omy ofT etmhpeo ral 9.C liniDciaalg nosi1s7 1 3 I Bonea ndS kull Base MatthRew.O 'MallMeDy , Aina]uliGaunlnyaMa D,, F ACS DaviSd.H ayneMsD, 2. Anatomoyf tTheem poraBlo nea nd 10. AudiologEivca luatoifoO nt ologic/ 29 SkulBla se 189 NeurotoloDgiisce ase AinJau liaGnunlay MaD,, F ACS BraAd. S tacPhh,D 3. Acoustiacnsd M echanicst hoef 11. 223 VestibuTleasrt ing 49 MiddlEea r I I. DenniBso jraMDb , I SaumNi.lM erchaMnDt , I SanjAa.yB hansaMlDi,F, A GS JohnR]o.s owsPkhiD, }. I TraviPsf annensMtD ieBl.,M ayaK atoM,D 4. 73 AuditoPrhyy siol:oI gnyneEra r 12. EndoscopDiica gnosainsd S urgeroyf I I VeronSitkaar liMnDg erK,i nukMoa sakPih,D 245 EustachiTaunb eD ysfnuction StefHaenl lPehrD, I DennSi.sP oeM,D ,F AGS 5. NeurophysiolTohgeyC :e ntral QuintGoonp enM,D 85 AuditoSryys tem 13. 255 Imaginogft heT emporaBlo ne I BradfoMrady],P. h D CharlLeism bM,D I GaldiEn.Vo a lvasMsDo ri, 6. VestibuPlhayrs ioloagnydD isorders MasouHde mn-iaMtDi , 113 oft heL abyrinth 14. 281 I HearinAgi ds TimotEh.Hy u llar,F AMGDS, I I Brad SAt.a cPhh,D NathaCn.P age, MLDl oyB.dM inoMr,D ,F ACS VirgiRnaina1 achanAdurDa n, 7. 137 GenetiicnsO tology and Neurotology I 15.T innitu2s9 3 AniKl.L alwaMnDi , I I ElinKaa ri, MDDo uglEa.Ms a ttoMxD, AnanNd. M hatrPeh,D Pnwel]]a.s trePbhoDf,f. SMcBDA, 8. 151 TumorB iology I 16. 307 D.B radlWeeyl liMnDg,,P hDF,A GS VestibuRleahra bilitation MarkD . PacMkDe r, MichaCe.Sl c hubePrTt,P ,h D vii viii CONTENTS • SECTIONI l.l FUNDAMENTALSO F SECTIONV. SURGERYO F THE OTOLOGICA ND NEUROTOLOGIC TYMPANOMASTOICDO MPARTMENT SURGERY 25. Patholoagnyd C liniCcoaulr soef t he InflammatDoirsye aseofst he 17. PrincipolfeT se mporaBlo nea nd 425 MiddlEea r 319 SkulBla seS urgery QuintGoonp enM,D I RoberAt.oC uevaM,D ,F ACS 26. 437 C.G aryJ acksMoDn,,F ACS AuraClo mplicatioofOn tsi tMiesd ia I ArvinKdu ma1M;D ,F RCS 18. 331 Laserisn O tology Richa\!Vride tM,D ,F ACS S. GeoLregsei nsMkDi , 27. lntracraCnoimapllic atioonfs 19. NeurophysiolMoogniict oriinnOg t ologic/ 451 OtitMiesd ia 349 NeurotoloSguircg ery I I SamueCl. L evinMeD,, F ACS RoberAt.oC uevaM,D ,F ACS I E. ChriDseS ouzMa.D,, FA .CS GayleH ickPsh,D ,D ABNM f. MichaeSlh inneMrDs , 359 20.E ndoscope-AssiEsatrSe udr gery 28. TympanoplasTtyym:p anic DenniSs.P oeM,D ,F ACS 465 MembraneR epair 21. Image-GuidSeyds temisn N eurotology/ AristiAdtehsa nasiadis-SMiDs,m.FA aCnSi s, 369 SkulBla seS urgery 29. 4 9 OssiculCahra inR econstructi8on M. MilGeosl dsmiMtDh,, FACS I AristiAdtehsa nasiadis-SMiDs,mF AaCnSi s, DenniSs.P oeM,D ,F ACS SECTIONI V. SURGERYO F THE 5 1 30.C anal-Wall-MUaps tiodectomy 0 EXTERNALE AR I David HSa.y neMsD, JustWiint tkoMpDf, 22. Diseasoesft heA uriclEex,t ernAauld itory 515 379 31.O penC avitMya stoiOdp erations Cana,la nd TympanMiecm brane I JohFn. K vetoMnD,, F ACS StephaMnoioed Ayn toniMoD, BarrSyt rasnMiDc,kF ,A CS 32. 529 Surgerfyo rO tosclerosis 23. I Surgerfyo rC anceorf t he OphiHra ndzeMlD,, L LB 397 ExternEaalr .MichJa.Me cl KennaMD, I KeithC aAs.p eMrD, MylePse nsaMkD,, F ACS 33.I mplantaMbilded lEea ra ndB one 24. 413 547 Surgerfyo rC ongenitAaulr aAlt reias ConductiHoena rinDge vices W I !v[D, I BradleyK essMe1D; CharlCe.sD ellSaa ntina,P hD RobeArt.J ahrsdoeMrDf er, Lal-vrenceL uRs.t iMgD,